Horrible preceptor rotations

[serimeri]

I know that a lot of DO schools vary in their rotations with some being more hospital based and some being preceptor based. However, I have to vent regarding the past few rotations I have had. My school tries to find community immigrant doctors and offers them the ability to become "academic associate professors" with a $500-600 monthly income for taking a student. Most of the time, we are being used as PA's or NP's to see and write notes that our precetors sign. WITHOUT EVEN ROUNDING ON THE PATIENTS WITH US OR EVEN HAVING THE DECENY TO SEE THE PATIENTS THEMSELVES. THAT IS NOT TEACHING! Other times, for a certain surgery rotation, I was expected to just be another scrub nurse in the OR as well as prepare the rooms. I kept my mouth silent and even if I vented to administration, they would not do anything. But for the past couple of months, it has gotten extreme, there is no teaching being done. For instance, I stayed in the hospital from 6AM-6PM today for my "joke of a Gen Surg rotation". Just because he had the ability to do so, for 4 hours I sat there, with no case, just because he wanted to have the power play. While one of my friends who had the luck to do an Opthalmology rotation for her 4th year, had a M-Th 9am-3PM rotation where the preceptor actually taught things well.

I'm pretty pissed about these experiences and I just want to know if my school is the one that is giving us these horrible preceptor based rotations where you DON'T LEARN ANYTHING from the attending physicians and study on your own.

Also, its really sad to see some anesthesiologists have such a complex issue that they think its appropriate to pimp a med student and then laugh with the nurses when the med student doesn't get the question 100% right. Just sad if you ask me. not that im trying to diss anesthesiologists or anything, but in my experience, this useless pimping thing has been more so with IMG physicians from India & Pakistan primarily. Not trying to be racist..I'm just telling it how I've seen it. They have some type of an ego issue.

---

Members don't see this ad.

 

[FutureDO2016]

Lolll just keep your head down, study and end the rotation and a new month will be here before you know it. Some preceptors suck and some are good, it's just the luck of the draw. Yes it's true most DO schools have poor preceptors but some are good too.

 

[s5260205]

Let me guess, AZCOM?

 

[Wolverines83]

Just study for your shelf and move on. Maybe report it to your school? As always, there's the option of slashing the attending's tires when you're done...

this useless pimping thing has been more so with IMG physicians from India & Pakistan primarily. Not trying to be racist..I'm just telling it how I've seen it. They have some type of an ego issue.

Yeah I've noticed that too. Spoke to an Indian resident who was born here and he shed some light on it. Basically, they're used to a strict rank structure and you as the student, are at the bottom of it. It's nothing personal at all and in their culture, they aren't dinguses for doing it. In our culture, however...

 

[serimeri]

I don't have a shelf for this one. But honestly, this is a recurrent problem with most of our rotations. Its really sad and pathetic.

I get that its their culture thing. What I think is that rotations should try and be standardized. At my school, the rotations with the nicest schedules, best learning, are just given out based on being on your coordinators good side. Its not fair, that someone gets the same or even less credit for doing 4X the work as another student and getting not much out of it.

Also, trust me, even if I reported it to my school, my school would yell at me for being a wuss. They would not do anything to change it and would say to suck it up. My school is so desparate for physicians to take their students its not even funny. It's futile complaining I know, but I have to get this out there. It is pure awful.

 

[serimeri]

Lolll just keep your head down, study and end the rotation and a new month will be here before you know it. Some preceptors suck and some are good, it's just the luck of the draw. Yes it's true most DO schools have poor preceptors but some are good too.

what are you suppose to do if you are getting poor rotation after rotation just because your school is too damn lazy to find quality preceptors? It's a shame we are spending this much money for such sh*tty preceptors.

I hate to play the race card again, but IMG preceptors don't know how to teach well in our system. They are from another system of teaching as another poster mentioned, and its not just a matter of getting over there thick accents, but they have outrageous expectations from medical students. I much prefer having american graduates teaching me, at least I will learn something valuable.

 

[s5260205]

Do you think preceptorship is the root of the problem (vs ward based)? It seems like there are good rotations but only if you get a good preceptor and they are very hard to come by considering the rotation sites are not large academic centres.

 

[Oo Cipher oO]

Staying from 6 AM to 6PM is kinda par for the course in Gen Surgery. What do you mean you act as another scrub nurse? Cause when I scrubbed in I was less effective then any scrub nurse but I tried my best not to slow down the surgeon and retracted and suctioned as best I could. I would never be allowed to help set up in the OR because the actual scrub nurses would, understandably, be so nervous I would contaminate something. I'm trying to understand what made your rotation any more horrible that it is anywhere else?

Also whats the problem with seeing patient and writing notes that your preceptors sign? Thats like...medicine.

 

[Siggy]

Staying from 6 AM to 6PM is kinda par for the course in Gen Surgery. What do you mean you act as another scrub nurse? Cause when I scrubbed in I was less effective as a scrub nurse but I tried my best not to slow down the surgeon and retracted and suctioned as best I could. I would never be allowed to help set up in the OR because the actual scrub nurses would, understandably, be so nervous I would contaminate something. I'm trying to understand what made your rotation any more horrible that it is anywhere else?

Also whats the problem with seeing patient and writing notes that your preceptors sign? Thats like...medicine.

Pfft, 5am to 5:30-6 for my OMS3 gen surgery rotation. My surgical sub I was in neurosx and included 3 straight weeks of nights (OK... I slept most of the time, but still...). Even as an intern, when I did an elective on anesthesiology, I helped turn the room over even though there was a anesthesiology tech that did that half the time (and I was rewarded with plenty of intubations).

As far as scrub tech/scrub nurse? Hahahahahaahah. Oh, wow. If I touched the Mayo I would have risked losing a finger.

 

[serimeri]

Do you think preceptorship is the root of the problem (vs ward based)? It seems like there are good rotations but only if you get a good preceptor and they are very hard to come by considering the rotation sites are not large academic centres.

I think the root of the problem is that the school does not make adequate efforts to ensure that the preceptors are passionate about teaching rather than just having access to an honorary professor certificate, or a free subscription to uptodate, or even just the opportunity to talk to a pretty young female student. I feel horrible writing these comments, but some of the preceptors have such a complex issue and such a power play some of the times. Its AWFUL.

There are good rotations but its tough being a private practitioner and making your own living, while also having a student to teach. Today's events just really sparked up my desire to write this post.

I truly hope, that as medical students with sub-par preceptor based rotations, we will not be totally helpless come time for residency.

 

[serimeri]

Staying from 6 AM to 6PM is kinda par for the course in Gen Surgery. What do you mean you act as another scrub nurse? Cause when I scrubbed in I was less effective as a scrub nurse but I tried my best not to slow down the surgeon and retracted and suctioned as best I could. I would never be allowed to help set up in the OR because the actual scrub nurses would, understandably, be so nervous I would contaminate something. I'm trying to understand what made your rotation any more horrible that it is anywhere else?

Also whats the problem with seeing patient and writing notes that your preceptors sign? Thats like...medicine.

That's actually against hospital policy to write notes at the hospital in question.

I am comparing the standard of the rotation to the opthalmology rotation I alluded to in my first post.

 

[serimeri]

Pfft, 5am to 5:30-6 for my OMS3 gen surgery rotation. My surgical sub I was in neurosx and included 3 straight weeks of nights (OK... I slept most of the time, but still...). Even as an intern, when I did an elective on anesthesiology, I helped turn the room over even though there was a anesthesiology tech that did that half the time (and I was rewarded with plenty of intubations).

As far as scrub tech/scrub nurse? Hahahahahaahah. Oh, wow. If I touched the Mayo I would have risked losing a finger.

I am a 4th year, so maybe I have some element of senioritis when I am doing more work than some of my colleagues on their surgical specialty rotations, but at least they get someone who teaches. I feel like I am just wasting my time bc this the best my school could get me. Rotation experiences should be standardized somewhat in my opinion.

 

[NurWollen]

I know that a lot of DO schools vary in their rotations with some being more hospital based and some being preceptor based. However, I have to vent regarding the past few rotations I have had. My school tries to find community immigrant doctors and offers them the ability to become "academic associate professors" with a $500-600 monthly income for taking a student. Most of the time, we are being used as PA's or NP's to see and write notes that our precetors sign. Other times, for a certain surgery rotation, I was expected to just be another scrub nurse in the OR as well as prepare the rooms. I kept my mouth silent and even if I vented to administration, they would not do anything. But for the past couple of months, it has gotten extreme, there is no teaching being done. For instance, I stayed in the hospital from 6AM-6PM today for my "joke of a Gen Surg rotation". Just because he had the ability to do so, for 4 hours I sat there, with no case, just because he wanted to have the power play. While one of my friends who had the luck to do an Opthalmology rotation for her 4th year, had a M-Th 9am-3PM rotation where the preceptor actually taught things well.

I'm pretty pissed about these experiences and I just want to know if my school is the one that is giving us these horrible preceptor based rotations where you DON'T LEARN ANYTHING from the attending physicians and study on your own.

Also, its really sad to see some anesthesiologists have such a complex issue that they think its appropriate to pimp a med student and then laugh with the nurses when the med student doesn't get the question 100% right. Just sad if you ask me. not that im trying to diss anesthesiologists or anything, but in my experience, this useless pimping thing has been more so with IMG physicians from India & Pakistan primarily. Not trying to be racist..I'm just telling it how I've seen it. They have some type of an ego issue.

Maybe I'm just a naive 2nd year, but what else do you expect? "My attending made me see patients, take and h&p, develop an assessment and plan." What a horror.

 

[serimeri]

Maybe I'm just a naive 2nd year, but what else do you expect? "My attending made me see patients, take and h&p, develop an assessment and plan." What a horror.

It's horrible and illegal when the attending, didn't even lay eyes on the patient. Essentially having a 3rd year student see the patients, write notes, without you ever seeing the patient or even explaining anything to the student is not teaching in my opinion.

I forgot to include this important tidbit in my original post. You are essentially just using someone for scutwork.

 

[Oo Cipher oO]

I am a 4th year, so maybe I have some element of senioritis when I am doing more work than some of my colleagues on their surgical specialty rotations, but at least they get someone who teaches. I feel like I am just wasting my time bc this the best my school could get me. Rotation experiences should be standardized somewhat in my opinion.

This whole thread makes so much more sense knowing you are a 4th year in late February.

 

[serimeri]

This whole thread makes so much more sense knowing you are a 4th year in late February.

Yes, but answer me this, is it fair to the student to not round on the patients with them or go over there notes with them? Should you really be signing consults on a patient without seeing them? What happened to some reasonable ethics?

For my surgery specialty rotation, don't you think I can be doing something productive during the 4-5 hours I stand around in the hall doing absolutely nothing. Why waste time?

 

[FutureDO2016]

ok just say what your school is....

and you're not the only one with bad preceptors...I know several established DO schools that still sometimes have bad preceptors...the problem is DO schools are NOT affiliated with major hospitals that can accommodate the whole class so people are sent to random core sites and that's just the name of the game...you should have applied to allopathic schools if this was such an issue for you but let me tell you even then you will sometimes get bad preceptors...it is unfortunate, you had so many, but why did you choose that core site...didn't you ask upperclassmen how the preceptors are at the core site before you selected it? In the end, you will be fine, you will be done with core sites soon and move on to electives and audition rotations and residency and this will just be a minor detour of your medical school journey.

 

[Oo Cipher oO]

Yes, but answer me this, is it fair to the student to not round on the patients with them or go over there notes with them? Should you really be signing consults on a patient without seeing them? What happened to some reasonable ethics?

For my surgery specialty rotation, don't you think I can be doing something productive during the 4-5 hours I stand around in the hall doing absolutely nothing. Why waste time?

Well it is the preceptor that is liable for those notes he signs. If they want to sign off on your note without validating it that is their problem. Do your job and move on. If you want to challenge yourself you can use this experience to try to function more as intern might rather then being hand held like most medical student are.

Doing nothing for 4-5 hours sounds like a horrible waste of time. Maybe you should try and do something (study, read, crochet, etc) to make the best of a bad situation. Sorry you didn't get the cush Optho rotation your friend does but life isn't fair. If you aren't learning from your preceptor then you have to learn on your own.

 

[serimeri]

ok just say what your school is....

and you're not the only one with bad preceptors...I know several established DO schools that still sometimes have bad preceptors...the problem is DO schools are NOT affiliated with major hospitals that can accommodate the whole class so people are sent to random core sites and that's just the name of the game...you should have applied to allopathic schools if this was such an issue for you but let me tell you even then you will sometimes get bad preceptors...it is unfortunate, you had so many, but why did you choose that core site...didn't you ask upperclassmen how the preceptors are at the core site before you selected it? In the end, you will be fine, you will be done with core sites soon and move on to electives and audition rotations and residency and this will just be a minor detour of your medical school journey.

I should have asked uperclassmen and that was my fault. I did do a few auditions as I am a 4th year now, and I learned a few things, but honestly I didn't do more than 3 audition due to financial constraints. This is not a huge issue for me but I just wanted to vent. However, I have made my bed and now I have to sleep on it. I just hope things improve. No one should have to be treated like this just because some 55 year old man just needs to feel superior. I want constructive criticism, not some guy just getting on my case.

 

[FutureDO2016]

so where did you match?! and what specialty?

 

[serimeri]

Well it is the preceptor that is liable for those notes he signs. If they want to sign off on your note without validating it that is their problem. Do your job and move on. If you want to challenge yourself you can use this experience to try to function more as intern might rather then being hand held like most medical student are.

Doing nothing for 4-5 hours sounds like a horrible waste of time. Maybe you should try and do something (study, read, crochet, etc) to make the best of a bad situation. Sorry you didn't get the cush Optho rotation you friend does but life isn't fair. If you aren't learning from your preceptor then you have to learn your own.

Thanks, I think I'm just in a whiny mood today and I needed to vent. I think from now on, if there is nothing to do, I am just going to go to the hospital cafe and read on my ipad. You are right life is not fair and I need to accept this and look at the positives. I will be able to function more as an intern and that counts for something.

 

[serimeri]

so where did you match?! and what specialty?

I have not matched as I am doing the MD match. I am most likely going to be doing IM or FM.

 

[FutureDO2016]

Best of luck in a few weeks! Instead of dwelling on the past, move on, once you graduate you can inform your school and give poor reviews of your core site and preceptors you had so no one else has to go through your hardships.

 

[serimeri]

Best of luck in a few weeks! Instead of dwelling on the past, move on, once you graduate you can inform your school and give poor reviews of your core site and preceptors you had so no one else has to go through your hardships.

Thank you. I will do that in hopes that future students do not make the same mistake. My school is such a money hounding institution its not even funny.

 

[serimeri]

Just study for your shelf and move on. Maybe report it to your school? As always, there's the option of slashing the attending's tires when you're done...


Yeah I've noticed that too. Spoke to an Indian resident who was born here and he shed some light on it. Basically, they're used to a strict rank structure and you as the student, are at the bottom of it. It's nothing personal at all and in their culture, they aren't dinguses for doing it. In our culture, however...

I would also like to add, as a word of advice, try and stay away from IMG's as preceptors if you have a choice. Their system is indeed different, and many of them are quite old and irritable in my experience.

 

[koan]

You want constructive criticism? Stop complaining and make the most of it. We are both fourth years and by now you should have learned how to navigate different personalities and expectations of a new rotation. Are you really complaining about a 12-hour shift? I'm on a 28-hour call shift in the ICU right now and it is AWESOME. I did two lumbar punctures tonight because I asked the attendings if they needed help. I had a bunch of down time in the afternoon so I read some articles on high altitude cerebral edema on uptodate. There is nothing here to report to your school; you are about to (hopefully) match and graduate and you just need to keep your head down as others suggested and tow the line.

And if you keep 'playing the race card' as you say and insisting that foreign doctors are terrible preceptors, and that anesthesiologists have inferiority complexes and just want to laugh at your expense...well, I just think you're going to make more enemies than friends with that attitude. I'd suggest trying to get along with your colleagues unless they do something truly inappropriate -- which I don't see here. Signing the note of a MS4 who did a thorough H&P with report could be interpreted as a sign of trust -- that you should be as capable as a fresh intern right now and not miss anything important.

Residency starts in about 4 months, and you'll be working harder than ever, getting pimped more, and making independent decisions more often. I think at this point preceptors have an expectation that a MS4 doesn't need coddling or hand-holding.

 

[Mass Effect]

I know that a lot of DO schools vary in their rotations with some being more hospital based and some being preceptor based. However, I have to vent regarding the past few rotations I have had. My school tries to find community immigrant doctors and offers them the ability to become "academic associate professors" with a $500-600 monthly income for taking a student. Most of the time, we are being used as PA's or NP's to see and write notes that our precetors sign. WITHOUT EVEN ROUNDING ON THE PATIENTS WITH US OR EVEN HAVING THE DECENY TO SEE THE PATIENTS THEMSELVES. THAT IS NOT TEACHING! Other times, for a certain surgery rotation, I was expected to just be another scrub nurse in the OR as well as prepare the rooms. I kept my mouth silent and even if I vented to administration, they would not do anything. But for the past couple of months, it has gotten extreme, there is no teaching being done. For instance, I stayed in the hospital from 6AM-6PM today for my "joke of a Gen Surg rotation". Just because he had the ability to do so, for 4 hours I sat there, with no case, just because he wanted to have the power play. While one of my friends who had the luck to do an Opthalmology rotation for her 4th year, had a M-Th 9am-3PM rotation where the preceptor actually taught things well.

I'm pretty pissed about these experiences and I just want to know if my school is the one that is giving us these horrible preceptor based rotations where you DON'T LEARN ANYTHING from the attending physicians and study on your own.

Also, its really sad to see some anesthesiologists have such a complex issue that they think its appropriate to pimp a med student and then laugh with the nurses when the med student doesn't get the question 100% right. Just sad if you ask me. not that im trying to diss anesthesiologists or anything, but in my experience, this useless pimping thing has been more so with IMG physicians from India & Pakistan primarily. Not trying to be racist..I'm just telling it how I've seen it. They have some type of an ego issue.

Actually, your post does sound very prejudiced, horribly entitled, and somewhat clueless, and unlike some of the others, I don't give you a pass because you're a fourth year. Your gen surg rotation is 12 hours a day? The horror. You're expected to help out? The horror. Just because you're a student doesn't mean you're above helping out. You're a 4th year. Why are you taking a gen surg elective anyway? Are you going into it? If so, then man up and learn this is what your life will be. If not, then you should have picked your rotations more carefully.

Secondly, you're complaining that you get to see patients and sign notes because the attending supposedly didn't see the patient? And you know this how? Are you attached at the hip? A good attending is seeing all these patients on his/her own when the 3rd year or 4th year is spending 2 hours on the H&P of another patient. Just because the attending doesn't round with you, doesn't mean he doesn't round. As for teaching, yes, some preceptors suck at teaching, so I'm not going to dismiss you on that claim. However, I do have to wonder if part of the reason they're not engaging in as much teaching as you'd like is because of your attitude. Just a thought.

It's horrible and illegal when the attending, didn't even lay eyes on the patient. Essentially having a 3rd year student see the patients, write notes, without you ever seeing the patient or even explaining anything to the student is not teaching in my opinion.

I forgot to include this important tidbit in my original post. You are essentially just using someone for scutwork.

Um, seeing patients and writing notes is not "scutwork" and if you think it is, then something went horribly wrong when you were researching this career.

 

[NurWollen]

All I know is that if my preceptors treat me like a PA or an NP, I'll be honored. Scared as hell, but honored. I'm a med student, and PA's and NP's know a lot more than I do at this point. An attending physician might have earned the right to question a PA or NP's knowledge base. Med students have not.

And I love Indians. My doctor is Indian. He's awesome. Maybe they are old school when it comes to pimping students because their culture still values respect for ones superiors.

 

[serimeri]

Actually, your post does sound very prejudiced, horribly entitled, and somewhat clueless, and unlike some of the others, I don't give you a pass because you're a fourth year. Your gen surg rotation is 12 hours a day? The horror. You're expected to help out? The horror. Just because you're a student doesn't mean you're above helping out. You're a 4th year. Why are you taking a gen surg elective anyway? Are you going into it? If so, then man up and learn this is what your life will be. If not, then you should have picked your rotations more carefully.

Secondly, you're complaining that you get to see patients and sign notes because the attending supposedly didn't see the patient? And you know this how? Are you attached at the hip? A good attending is seeing all these patients on his/her own when the 3rd year or 4th year is spending 2 hours on the H&P of another patient. Just because the attending doesn't round with you, doesn't mean he doesn't round. As for teaching, yes, some preceptors suck at teaching, so I'm not going to dismiss you on that claim. However, I do have to wonder if part of the reason they're not engaging in as much teaching as you'd like is because of your attitude. Just a thought.



Um, seeing patients and writing notes is not "scutwork" and if you think it is, then something went horribly wrong when you were researching this career.

I do not mind seeing the patients. However, when preceptors take students to just get free labor and do absolutely ZERO teaching, I think that is unfair and unethical.

I know that the preceptor in question did not see the patients, some of which he was the Primary admitting physician on some of them as well as specialist, because a few of the patients kept on complaining to me about how they needed to see him and he hadn't seen them the entire stay. The nurses would ask me when he would be coming because they needed orders to be filled in. One of the patients had an elevated WBC count, I texted him regarding the patient politely, and he told me to stop bothering him and he'll come when he thinks its appropriate. He is suppose to be following up on them everyday himself. We as medical students would write the notes (STRICTLY AGAINST HOSPITAL POLICY) and he hadn't signed the charts electronically in days. I think its just plain unethical to agree to be a preceptor and do absolutely ZERO teaching. This also jeopardizes patient safety.

It has nothing to do with "my attitude" because all of the students who rotated with him experienced the same thing. When we complained to our school, they said they would not have students rotate with him again, but since they are so desparate for preceptors, they did not honor their word.

Also, I did not do this general surgery rotation because I loved surgery or have any remote desire of going into it. I did it because our school requires 4th years to do a rotation. in some type of subspecialty of surgery. I was trying to get an Opthalmology or ENT rotation, but since I did not fill my request 90 days in advance, I was unable to get my request filled and was stuck with general surgery.

To tell you the truth, I have no problem helping out in the OR. In fact, I enjoy interacting with some of the scrub techs. However, I don't see why I should be stranded for 4 hours, with nothing productive to do. I am paying for an education and I am trying to make the best of it. I just needed to vent these concerns so as to see if I am alone in this preceptor based education system. You might think I'm a wuss for complaining and that is fine.

 

[as90]

What race are you? I am Indian and I am completely offended by your remarks about people from my motherland. We have made good contributions to this society by working hard day in and day out. My father and mother came to this country with $2, he worked at the 99cent store, yet he still managed to support 3 children. I am a first generation Indian American and I have appreciate everything my parents have done for me and taught me. This type of training and pimping will help you for residency and keep your head down. I think the system in america focuses too much on individuality and extrovertism, but it does not teach respect for elders. You need to give your preceptors authority and they will teach you and give you good evaluations. I am completely offended by your racist comments.

 

[ERK123]

What race are you? I am Indian and I am completely offended by your remarks about people from my motherland. We have made good contributions to this society by working hard day in and day out. My father and mother came to this country with $2, he worked at the 99cent store, yet he still managed to support 3 children. I am a first generation Indian American and I have appreciate everything my parents have done for me and taught me. This type of training and pimping will help you for residency and keep your head down. I think the system in america focuses too much on individuality and extrovertism, but it does not teach respect for elders. You need to give your preceptors authority and they will teach you and give you good evaluations. I am completely offended by your racist comments.

It is not racist to not want to completely defer to ones elders. I am not saying OP is right or wrong in his complaint, but I do not think that respect should be given simply based on age.

 

[as90]

It is not racist to not want to completely defer to ones elders. I am not saying OP is right or wrong in his complaint, but I do not think that respect should be given simply based on age.

The OP made multiple derogatory and racist remarks regarding Indian preceptors and pimping. These people are doing you a huge service by trying to expose the deficiencies in your knowledge base that exist as an MS3. I also don't like the superiority in the OP's remarks regarding PA's and NP's, they know more than you know at this level of your training.

The indian caste/class system gave rise to this societies class system and the hierarchy that exists in our medical profession. Think about hierarchy that exists when you hurridly grab your attendings coffee in the morning.

 

[NurWollen]

The OP made multiple derogatory and racist remarks regarding Indian preceptors and pimping. These people are doing you a huge service by trying to expose the deficiencies in your knowledge base that exist as an MS3. I also don't like the superiority in the OP's remarks regarding PA's and NP's, they know more than you know at this level of your training.

The indian caste/class system gave rise to this societies class system and the hierarchy that exists in our medical profession. Think about hierarchy that exists when you hurridly grab your attendings coffee in the morning.

This × 1000

 

[Doctor Bob]

Think about hierarchy that exists when you hurridly grab your attendings coffee in the morning.

Woah woah woah.... hang on a sec.


You mean I can get med students to go get my coffee?

I have definitely been doing something wrong.

 

[hallowmann]

...I hate to play the race card again, but IMG preceptors don't know how to teach well in our system. They are from another system of teaching as another poster mentioned, and its not just a matter of getting over there thick accents, but they have outrageous expectations from medical students. I much prefer having american graduates teaching me, at least I will learn something valuable.

I would also like to add, as a word of advice, try and stay away from IMG's as preceptors if you have a choice. Their system is indeed different, and many of them are quite old and irritable in my experience.

You're extrapolating your handful of experiences of poor teaching in non-academic settings (due apparently to your own procrastination) with IMG preceptors, specifically Indian & Pakistani ones apparently, and saying this is the case with all, and students should avoid IMGs at all costs. You do realize that a quarter of practicing physicians in this country are IMGs, and many of them are effective and succesful educators in academic settings, right?

Why would you jump to a conclusion based on country of national origin/education, when the much more likely conclusion is that your school sent you to a poorly organized rotation?

Anyway, like many have said, make the best of the situation. I strongly recommend evaluating your preceptor to your school as well as other students, but if you actually want it to be taken seriously and not just interpreted as complaining, I'd leave out things like hours/scutwork and focus on the lack of real education.

 

[serimeri]

Clearly I have offended a lot of you guys. I am sorry for that.

I also did not mean to extrapolate but I have had several experiences with IMG's from the indian subcontinent where they enjoy publicly humiliating students to boost their ego. On the contrary, I have had a few Carribea grad& DO attendings also from India, who have been the best focused and organized teachers you could ever even imagine. My 3rd year gen surg core rotation was so organized and the guy was a DO from Sri Lanka originally. So it is the luck of the draw sometimes.

I just needed to vent and I sincerely apologize for any deragotry comments.

 

[as90]

II

Woah woah woah.... hang on a sec.


You mean I can get med students to go get my coffee?

I have definitely been doing something wrong.

Yes u have. Also make sure you buy Starbucks for everyone in the office if u want a good eval

 

[jakeislove]

Getting pimped is a part of medical student life.

You're supposed to have their money!

 

[hallowmann]

Getting pimped is a part of medical student life.

You're supposed to have their money!

Don't you worry, I said hey...

 

[thepoopologist]

I do not mind seeing the patients. However, when preceptors take students to just get free labor and do absolutely ZERO teaching, I think that is unfair and unethical.

I agree. During medical school I think if someone taught at all, whether good or bad, I'd be grateful because the worst rotations were the ones where I wasn't engaged at all. It's what happens when the schools sticks students with community docs whom haven't read a book in years and are 100% focused on volume and money. I think the result of medical student rotations I had that were uncomfortable, lots of work, and endless amounts of teaching and pimping, was my absolute ease in that area when I became a resident. As a psych intern on medicine I was once pimped for 10 minutes straight and owned the **** out of it. The same me as an M3 on medicine was a nervous wreck. The rotations where I was taught nothing or skidded by, well, the weaknesses were found during residency and pounded into oblivion. What can you possibly do? If this is the best the school offers, then so be it. Then you learn what you can and focus on passing all rotations so you can get a degree. If you want to be crazy about it, you can write something nuts in the documentation and see if your attending is paying any attention at all. If he doesn't, at least you can assure yourself that he'll be in for a lawsuit sometime down the road. I'm kidding. Sort of.

 

[gogolmd]

.

 

[as90]

Pimping is part of your tuition. you should be thanking them for pimping you. it will prepare u for residency.

what i love doing is writing all my pimping quetions, then looking them up on uptodate, and do reverse pimping on the attending. You guys have got to learn confidence as medical students too. There was one student a colleague of mine, who was always so shy and nervous, he knew his stuff, but he could not look confident. Acting like you know your stuff and not being nervous are two important traits in medicine. Do you want a doc who looks&sounds like they don't know what their doing?

 

[as90]

I agree. During medical school I think if someone taught at all, whether good or bad, I'd be grateful because the worst rotations were the ones where I wasn't engaged at all. It's what happens when the schools sticks students with community docs whom haven't read a book in years and are 100% focused on volume and money. I think the result of medical student rotations I had that were uncomfortable, lots of work, and endless amounts of teaching and pimping, was my absolute ease in that area when I became a resident. As a psych intern on medicine I was once pimped for 10 minutes straight and owned the **** out of it. The same me as an M3 on medicine was a nervous wreck. The rotations where I was taught nothing or skidded by, well, the weaknesses were found during residency and pounded into oblivion. What can you possibly do? If this is the best the school offers, then so be it. Then you learn what you can and focus on passing all rotations so you can get a degree. If you want to be crazy about it, you can write something nuts in the documentation and see if your attending is paying any attention at all. If he doesn't, at least you can assure yourself that he'll be in for a lawsuit sometime down the road. I'm kidding. Sort of.

This type of thing happens a lot. But you have to voice your concerns to the school. But think about the honor, you are able to write notes and can bill for it, aren't you guys thrilled that you have attained that level of trust in the eyes of insurance companies? It means you can moonlight in urgent care soon too!

I would be totally elated if I had the opportunity to write all of my attendings notes and he will just bill from there.

 

[thepoopologist]

This type of thing happens a lot. But you have to voice your concerns to the school. But think about the honor, you are able to write notes and can bill for it, aren't you guys thrilled that you have attained that level of trust in the eyes of insurance companies? It means you can moonlight in urgent care soon too!

I would be totally elated if I had the opportunity to write all of my attendings notes and he will just bill from there.

The M3 or M4 should be taught how to document in a manner that reflects their thought process with regards to a patient's clinical presentation. This documentation should be reviewed by an attending/senior resident who can make sure that the M3/M4 does not miss anything and is thorough in their development of an assessment and treatment plan. They should do this because that student will be a resident one day and if they were not taught well as a student then with this faulty way of thinking they will look either like idiots, or if they go to a crappy program, will start killing people. Not because of their inability to write notes, but their inability to think things out and be comprehensive because the idea behind the notes was not honored. An attending who lets an M3/M4 write notes without review is a lazy attending, regardless of the M3/M4's abilities as a student and shows a complete disrespect for the student's primary purpose of being there, which is to learn first, and second to do the attendings bidding. Not the other way around.

 

[Tizoc]

Getting pimped is a part of medical student life.

You're supposed to have their money!

"What's this? Mr. Franklin's lonely!"

 

[NontradCA]

Well it is the preceptor that is liable for those notes he signs. If they want to sign off on your note without validating it that is their problem. Do your job and move on. If you want to challenge yourself you can use this experience to try to function more as intern might rather then being hand held like most medical student are.

Doing nothing for 4-5 hours sounds like a horrible waste of time. Maybe you should try and do something (study, read, crochet, etc) to make the best of a bad situation. Sorry you didn't get the cush Optho rotation your friend does but life isn't fair. If you aren't learning from your preceptor then you have to learn on your own.

Haha crochet.

 

[Thought Crime Spree]

Thanks to VSAS I've done quite a few rotations at MD institutions with their own hospitals and what a contrast to the experience at my DO school. At the MD places they have all had organized curriculum and reading associated with the rotation, lots of attending teaching, lectures, procedure labs, lots of patient contact and opportunities for presenting and thoughtful feedback.

Compare that to some rotations that were 100% shadowing, or an IM rotation where the attending's orientation was "here's your computer, that's my login, just dictate H&P's and discharge summaries on time so I get paid kthnksbye". I then saw him for ~10 minutes a day when he breezed through to do progress notes, never presented a patient or got any feedback on my notes or had any teaching the entire month.

 

[NurWollen]

Thanks to VSAS I've done quite a few rotations at MD institutions with their own hospitals and what a contrast to the experience at my DO school. At the MD places they have all had organized curriculum and reading associated with the rotation, lots of attending teaching, lectures, procedure labs, lots of patient contact and opportunities for presenting and thoughtful feedback.

Compare that to some rotations that were 100% shadowing, or an IM rotation where the attending's orientation was "here's your computer, that's my login, just dictate H&P's and discharge summaries on time so I get paid kthnksbye". I then saw him for ~10 minutes a day when he breezed through to do progress notes, never presented a patient or got any feedback on my notes or had any teaching the entire month.

Were you able to do 3rd year rotations through VSAS or just 4th year rotations?

 

[Thought Crime Spree]

Just 4th year.

 

[hallowmann]

Were you able to do 3rd year rotations through VSAS or just 4th year rotations?

VSAS is only 4th year, but some MD places take 3rd years from non-affiliates. They're a pain to find, but its possible.